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Rodrigues PSM, Shimano MM, de Oliveira E, Kawamura FM, Silveira AF, José Luvizutto G, de Souza LAPS. Adaptation and clinical application of assistive device chair for bedside sitting in acute stroke phase: two case reports. Disabil Rehabil Assist Technol 2024; 19:1272-1278. [PMID: 36630593 DOI: 10.1080/17483107.2023.2166600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 11/16/2022] [Accepted: 01/05/2023] [Indexed: 01/13/2023]
Abstract
PURPOSE This report presents the adaptation of an assistive device chair for bedside sitting and its application in two patients with trunk control impairment in the acute stroke phase. MATERIALS AND METHODS The device was built with polyvinylchloride (PVC) pipes and designed by a team of mechanical engineers and physiotherapists to maintain a prolonged sitting position with less demand from therapists. To test the device, two patients were followed up during the acute phase of stroke. Both patients underwent an early mobilization program (30 min, twice a day, for three days) with an assistive device chair for bedside sitting. Patients were evaluated using the National Institutes of Health Stroke Scale (NIHSS), Trunk Impairment Scale (TIS), and International Classification of Functioning, Disability, and Health (ICF) checklist (b: body function; d: activity and participation). RESULTS The adaptations generated the following equipment: 1) foldable, 2) three levels of backrest inclination, and 3) a safety anterior support or an activity table. Both patients showed clinical improvement after the intervention period, with NIHSS score reduction, TIS improvement, and greater functionality and independence on the ICF framework. CONCLUSION The equipment with adaptations seems to be functional, easy to handle, and can potentially contribute to clinical and functional improvements in patients with trunk control deficits after stroke.
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Affiliation(s)
| | - Marcos Massao Shimano
- Department of Mechanical Engineering, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Edimar de Oliveira
- Student of the Mechanical Engineering, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Fábio Masao Kawamura
- Student of the Mechanical Engineering, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Ana Flávia Silveira
- Doctorate Student in Physiotherapy, Federal University of São Carlos, São Carlos, Brazil
| | - Gustavo José Luvizutto
- Department of Applied Physiotherapy, Federal University of Triângulo Mineiro, Uberaba, Brazil
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van der Waal C, Embrechts E, Truijen S, Saeys W. Do we need to consider head-on-body position, starting roll position and presence of visuospatial neglect when assessing perception of verticality after stroke? Top Stroke Rehabil 2024; 31:244-258. [PMID: 37671676 DOI: 10.1080/10749357.2023.2253622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/27/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND AND OBJECTIVE Considering various factors that influence the accuracy of the Subjective Visual Vertical (SVV) and Subjective Postural Vertical (SPV), standardization of assessment methods is needed. This retrospective study examined the contribution of Head-on-Body (HOB) position, starting roll position (SRP) and visuospatial neglect (VSN) to SVV and SPV constant errors (i.e. deviation from true vertical). Also, the contribution of HOB position and VSN presence to SVV and SPV variability (i.e. intra-individual consistency between trials) was assessed. METHODS First-ever unilateral hemispheric stroke survivors (<85 years; <100 days post-stroke) were assessed with three HOB positions (neutral, contralesional, and ipsilesional) and seven starting positions (20°Contralesional to 20° ipsilesional) of the laser bar and tilt chair. Linear mixed models were selected to evaluate the contribution of HOB, SRP, and VSN to SVV/SPV constant errors and variability. RESULTS Thirty-four subjects (24 VSN-/10 VSN+) were assessed. A tilted HOB position led to significantly higher constant errors for the SVV and SPV (the latter only in the VSN- group), and an increased SVV variability. SRP only significantly contributed to the SVV constant errors and only in the VSN- group. Furthermore, the presence of VSN resulted in a significantly higher SVV and SPV variability. CONCLUSIONS HOB position and the presence of SRP and VSN are important factors to consider during SVV and SPV measurements. Assessment with a neutral HOB position leads to more accurate results. HOB position and SRP influence the results of SVV and SPV differently in individuals with and without VSN, which highlights the relevance of VSN assessment.
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Affiliation(s)
- Charlotte van der Waal
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Elissa Embrechts
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
- Department of Experimental Neuropsychology, Helmholtz Institute, Utrecht University, Utrecht, Netherlands
| | - Steven Truijen
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Wim Saeys
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
- Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
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Nolan J, Jacques A, Godecke E, Bynevelt M, Dharsono F, Singer B. Lateropulsion resolution and outcomes up to one year post-stroke: a prospective, longitudinal cohort study. Top Stroke Rehabil 2024:1-12. [PMID: 38526999 DOI: 10.1080/10749357.2024.2333186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/17/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Post-stroke lateropulsion is prevalent and associated with poor rehabilitation outcomes; however, data regarding long-term function associated with lateropulsion are lacking. OBJECTIVES This study aimed to explore lateropulsion resolution and associations between lateropulsion, functional outcomes, and fall occurrence up to 12 months post-stroke. METHODS Participants for this prospective, longitudinal cohort study were recruited from a Stroke Rehabilitation Unit (SRU). Assessments were conducted at SRU admission, at discharge, and at three, six, nine, and twelve months post-stroke. Outcomes included the Four-Point Pusher Score (4PPS), Functional Independence Measure (FIM), and fall occurrence. Longitudinal outcomes were modeled using generalized linear mixed-effects models. RESULTS The final analyses included data from 144 participants. Eighty-two participants (56.9) had lateropulsion (4PPS ≥ 1) on admission. Odds of resolved lateropulsion (4PPS = 0) increased longitudinally from discharge for people who participated in rehabilitation physiotherapy (OR: 9.7, 28.1, 43.1, 81.3: <0.001 at three, six, nine, and twelve months respectively). The greatest FIM improvement among participants in all 4PPS categories occurred during the SRU inpatient phase. The probability of falls post-discharge was greatest among participants with 4PPS = 1 at three months, when compared with 4PPS = 0 (p= 0.022). CONCLUSIONS This study showed that lateropulsion can continue to resolve up to one year post-stroke. Earlier lateropulsion resolution was associated with ongoing rehabilitation physiotherapy participation. Long-term functional gains were maintained among people discharged home, whereas functional status deteriorated after six months among those in residential care. Study findings will allow rehabilitation and service providers to better plan for and accommodate the long-term rehabilitation and care needs of people with post-stroke lateropulsion.
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Affiliation(s)
- Jessica Nolan
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
- School of Health Sciences, The University of Notre Dame Australia, Fremantle, Australia
- Physiotherapy Department, Sir Charles Gairdner Osborne Park Health Care Group, Nedlands, Australia
| | - Angela Jacques
- The Institute for Health Research, The University of Notre Dame Australia, Fremantle, Australia
- Department of Research, Sir Charles Gairdner Osborne Park Health Care Group, Nedlands, Australia
| | - Erin Godecke
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
- Allied Health Research, Sir Charles Gairdner Osborne Park Health Care Group, Nedlands, Australia
- Centre of Research Excellence in Aphasia Rehabilitation, La Trobe University, Melbourne, Australia
| | - Michael Bynevelt
- The Neurological Intervention and Imaging Service of Western Australia, Nedlands, Australia
| | - Ferry Dharsono
- The Neurological Intervention and Imaging Service of Western Australia, Nedlands, Australia
| | - Barbara Singer
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
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Nolan J, Godecke E, Spilsbury K, Singer B. Post-Stroke Lateropulsion: Resolution and Function After Discharge From Inpatient Rehabilitation - A Cohort Study. Physiother Can 2023; 75:264-268. [PMID: 37736404 PMCID: PMC10510537 DOI: 10.3138/ptc-2021-0078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 09/23/2023]
Abstract
Purpose A person with post-stroke lateropulsion pushes their body toward their hemiparetic side and/or resists accepting weight onto their nonparetic side. Research findings regarding long-term persistence of lateropulsion and its association with function are lacking. This study reports associations between lateropulsion severity (Four Point Pusher Score - 4PPS) and functional outcome (Functional Independence Measure - FIM) at three months after discharge. Methods This prospective cohort study included 41 consecutive admissions to a stroke rehabilitation unit. Lateropulsion severity and FIM were measured at admission, discharge and three-month follow-up. Lateropulsion status at discharge, stroke laterality, ongoing physiotherapy after discharge, and demographic variables (age and sex) were tested for association with FIM change over the follow-up period. Results Complete data were available for 38 participants. Among these, 17 (44.7%) showed lateropulsion (4PPS ≥ 1) on admission, 9 (23.7%) showed persistent lateropulsion on discharge, and 7 (18.4%) showed persistent lateropulsion at three month follow-up. Improved functional status (FIM score) was seen at follow-up in those discharged with lateropulsion who had right-sided lesions but not in those with left-sided lesions. Conclusions Lateropulsion can continue to resolve after discharge from inpatient rehabilitation. Larger cohort studies are needed to further explore associations between persistent lateropulsion and long-term outcomes.
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Affiliation(s)
- Jessica Nolan
- From the:
School of Medical and Health Sciences, Edith Cowan University, Joondalup, W.A., Australia
- Osborne Park Hospital, Stirling, W.A., Australiea
| | - Erin Godecke
- From the:
School of Medical and Health Sciences, Edith Cowan University, Joondalup, W.A., Australia
- Sir Charles Gairdner Hospital, Nedlands, W.A., Australia
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Vict., Australia
| | - Katrina Spilsbury
- Institute for Health Research, University of Notre Dame Australia, Fremantle, W.A., Australia
| | - Barbara Singer
- Training Centre in Subacute Care, South Metropolitan Health Service, Fremantle Hospital, Fremantle, W.A., Australia
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van der Waal C, Embrechts E, Loureiro-Chaves R, Gebruers N, Truijen S, Saeys W. Lateropulsion with active pushing in stroke patients: its link with lesion location and the perception of verticality. A systematic review. Top Stroke Rehabil 2023; 30:281-297. [PMID: 35102816 DOI: 10.1080/10749357.2022.2026563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Lateropulsion with active Pushing (LwP) is characterized by impairments in postural control. Previous research suggests an association between LwP, lesion location and verticality misperception. This first-ever systematic review evaluates the association between LwP, lesion location and the perception of verticality (PROSPERO: CRD42020159248). METHODS PubMed, Web of Science, REHABDATA, Embase, Cochrane Library and PEDro were systematically searched on December 16, 2021. Studies were included when examining lesion location or perception of verticality (Subjective Haptic, Visual or Postural Vertical) in supratentorial stroke patients showing LwP. Two reviewers independently screened and assessed risk of bias using the Newcastle Ottawa Scale. Data were qualitatively analyzed and extracted. RESULTS Nineteen studies were included, examining a total of 340 LwP patients. Lesions in: the thalamus, internal capsule, inferior parietal lobule at the junction of the postcentral gyrus, the posterior insula and the superior temporal gyrus, were associated with LwP. Whereas all studies examining the Subjective Postural and Haptic Vertical (haptic only examined once) reported a significant increased deviation in LwP patients, inconsistent results were found for the Subjective Visual Vertical. Furthermore, the Subjective Visual and Postural Vertical showed inconsistent results for magnitude, direction and variability of this deviation. DISCUSSION A complex brain network, rather than only one brain region, seems responsible for body control with respect to gravity. A disruption within this network might lead to a bias in the construction of a correct internal reference frame, crucial for perceiving verticality. There was an association of LwP with verticality misperception in all three modalities.
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Affiliation(s)
- Charlotte van der Waal
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Elissa Embrechts
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Renata Loureiro-Chaves
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Nick Gebruers
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Steven Truijen
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Wim Saeys
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium.,Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
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Nolan J, Godecke E, Spilsbury K, Wu A, Singer B. Accuracy of the Australian National Sub-Acute and Non-Acute Patient Classification in predicting rehabilitation length of stay for stroke survivors who are ≥65 years of age and have lateropulsion. Top Stroke Rehabil 2023; 30:203-211. [PMID: 35068380 DOI: 10.1080/10749357.2021.2008594] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Lateropulsion is a common impairment after stroke. Regardless of stroke severity, functional recovery is slower in people with lateropulsion, resulting in requirement for longer rehabilitation duration. In Australia, inpatient rehabilitation funding is determined via the Australian National Sub-Acute and Non-Acute Patient Classification (AN-SNAP). AN-SNAP class is determined using age, diagnosis, weighted Functional Independence Measure (FIM) motor score, and FIM cognitive score. OBJECTIVES To explore accuracy of the AN-SNAP to predict length of stay (LOS) for people with poststroke lateropulsion. METHODS A retrospective database audit was undertaken. AN-SNAP predicted LOS for each participant was calculated based on 2019 calendar year national benchmarks. A multivariable linear regression model estimated mean differences in reported LOS and AN-SNAP predicted LOS after adjusting for lateropulsion severity (Four Point Pusher Score). A separate logistic regression model assessed whether FIM change during admission was associated with reported LOS exceeding AN-SNAP predicted LOS. RESULTS Data were available from 1126 admissions. Reported LOS exceeding AN-SNAP predicted LOS was associated with greater lateropulsion severity on admission. Where AN-SNAP predicted LOS was longer, those with no lateropulsion on admission showed shorter reported than predicted LOS. Greater improvement in FIM during rehabilitation was associated with increased odds of reported LOS exceeding AN-SNAP predicted LOS (OR 1.02, 95%CI 1.01-1.03, p < .001). CONCLUSIONS Inclusion of a measure of poststroke lateropulsion in the AN-SNAP classification model would result in more accurate LOS predictions to inform funding. Costs of longer rehabilitation LOS may be countered by optimized long-term physical function, reducing requirement for ongoing care.
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Affiliation(s)
- Jessica Nolan
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia.,Physiotherapy Department, Osborne Park Hospital, Stirling, Western Australia
| | - Erin Godecke
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia.,Allied Health, Sir Charles Gairdner Hospital, Nedlands, Western Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne
| | - Katrina Spilsbury
- Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia
| | - Andy Wu
- Strategy, Policy and Intergovernmental Relations Directorate, Department of Health, East Perth, Western Australia
| | - Barbara Singer
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia.,Training Centre in Subacute Care, South Metropolitan Health Service, Fremantle Hospital, Fremantle, Western Australia
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Riera-Tur L, Antúnez-Estudillo E, Montesinos-González JM, Martín-Mateos AJ, Lechuga-Sancho AM. Test-retest of the Subjective Visual Vertical Test performed using a mobile application with the smartphone anchored to a turntable. Eur Arch Otorhinolaryngol 2023; 280:613-621. [PMID: 35838781 DOI: 10.1007/s00405-022-07512-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/14/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE The alterations of the Subjective visual vertical test are related to vestibular pathology. Our previously validated method to distinguish between healthy and pathological individuals measures the deviation from the Subjective visual vertical using a mobile application installed on a smartphone fixed to a turntable anchored to the wall. The aim of this study was evaluating the intra-observer reliability of our method in individuals with or without vestibular pathology. METHODS Participants were recruited consecutively. In each individual two measurements with an interval of 2 h were made. Both tests were performed by the same examiner. A total of 91 patients were included in this study, of which 25 were healthy and 66 diseased. Intra-observer reliability was evaluated using the intraclass correlation coefficient (ICC). To assess the clinical accuracy of the measurement, we calculated the standard error of the measurement (SEM) and the minimum detectable change (MDC) with a 95% confidence interval. RESULTS Intra-observer reliability was excellent with an ICC 0.95 (0.92-0.97) in the whole sample, in healthy patients 0.91 (0.80-0.96) and in pathological patients 0.92 (0.87-0.95). The SEM was calculated to be 0.59 for the whole sample (0.26 in the "healthy" group, and 0.67 in the pathological group). Likewise, the sample's MDC was 1.16, being 0.52 and 1.36 for the healthy and the pathological group, respectively. CONCLUSIONS Considering the results, our method presents an excellent intraobserver reliability. Furthermore, changes in deviation greater than 0.52 in healthy individuals and 1.36 in pathological individuals can be considered a real change in deviation.
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Affiliation(s)
- Laura Riera-Tur
- Department of Otolaryngology, Puerta del Mar University Hospital, Av. Ana de Viya 21, 11009, Cádiz, Spain. .,Department of Child and Mother Health and Radiology, Medical School, University of Cádiz, Cádiz, Spain. .,Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain.
| | - Encarnación Antúnez-Estudillo
- Department of Otolaryngology, Puerta del Mar University Hospital, Av. Ana de Viya 21, 11009, Cádiz, Spain.,Department of Child and Mother Health and Radiology, Medical School, University of Cádiz, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
| | - Juan M Montesinos-González
- Department of Otolaryngology, Puerta del Mar University Hospital, Av. Ana de Viya 21, 11009, Cádiz, Spain.,Department of Child and Mother Health and Radiology, Medical School, University of Cádiz, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
| | - Antonio J Martín-Mateos
- Department of Otolaryngology, Puerta del Mar University Hospital, Av. Ana de Viya 21, 11009, Cádiz, Spain.,Department of Child and Mother Health and Radiology, Medical School, University of Cádiz, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
| | - Alfonso M Lechuga-Sancho
- Department of Otolaryngology, Puerta del Mar University Hospital, Av. Ana de Viya 21, 11009, Cádiz, Spain.,Department of Child and Mother Health and Radiology, Medical School, University of Cádiz, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
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Abstract
The frontal lobe is crucial and contributes to controlling truncal motion, postural responses, and maintaining equilibrium and locomotion. The rich repertoire of frontal gait disorders gives some indication of this complexity. For human walking, it is necessary to simultaneously achieve at least two tasks, such as maintaining a bipedal upright posture and locomotion. Particularly, postural control plays an extremely significant role in enabling the subject to maintain stable gait behaviors to adapt to the environment. To achieve these requirements, the frontal cortex (1) uses cognitive information from the parietal, temporal, and occipital cortices, (2) creates plans and programs of gait behaviors, and (3) acts on the brainstem and spinal cord, where the core posture-gait mechanisms exist. Moreover, the frontal cortex enables one to achieve a variety of gait patterns in response to environmental changes by switching gait patterns from automatic routine to intentionally controlled and learning the new paradigms of gait strategy via networks with the basal ganglia, cerebellum, and limbic structures. This chapter discusses the role of each area of the frontal cortex in behavioral control and attempts to explain how frontal lobe controls walking with special reference to postural control.
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Affiliation(s)
- Kaoru Takakusaki
- Department of Physiology, Division of Neuroscience, Asahikawa Medical University, Asahikawa, Japan.
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Cronin E, Broderick P, Clark H, Monaghan K. What are the effects of pilates in the post stroke population? A systematic literature review & meta-analysis of randomised controlled trials. J Bodyw Mov Ther 2023; 33:223-232. [PMID: 36775522 DOI: 10.1016/j.jbmt.2022.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/10/2022] [Accepted: 09/24/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Stroke is a leading cause of death and disability worldwide. Pilates, a programme of mind-body exercises is theorised to have beneficial effects on strength, postural control, balance, proprioception, coordination and gait in people with deficits due to a neurological condition. However, the evidence of pilates in stroke patients has never been systemised. The objectives of this systematic literature review are to investigate the effects of pilates in post stroke individuals and compare this intervention to other forms of exercise, standard care and/or physiotherapy. DATA SOURCES A comprehensive search was conducted in the following databases: Pubmed (including MEDline), Web of Science, the Cochrane library, Science Direct, Embase and PEDro. STUDY SELECTION Studies were selected, screened, filtered and reviewed in detail to identify those that met the inclusion criteria. DATA EXTRACTION Data was extracted to a table with specific headings for analysis and studies were rated using the Physiotherapy Evidence Database (PEDro) scale. DATA SYNTHESIS Data from a total of 5 included studies with 122 participants was pooled and analysed using the Revman 5 software. Significant findings were found in favour of the pilates intervention groups on balance (P<0.00001), quality of Life (P=0.0002), and gait parameters (P=0.001), when results from the studies were combined and analysed. CONCLUSIONS This review found moderate evidence for pilates exercises improving balance in post stroke individuals and limited evidence for improvements in quality of life, cardiopulmonary function and gait. Future studies should examine long term follow up, home programmes and comparisons with other forms of exercise in post stroke patients.
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Affiliation(s)
- Eimear Cronin
- Neuroplasticity Research Group, Clinical Health and Nutrition Centre (CHANCE), School of Science, Atlantic Technological University, Sligo, Ireland; HSE Physiotherapy Department, St. John's Hospital, Sligo, Ireland.
| | - Patrick Broderick
- Neuroplasticity Research Group, Clinical Health and Nutrition Centre (CHANCE), School of Science, Atlantic Technological University, Sligo, Ireland
| | - Helen Clark
- HSE Sligo University Hospital, Sligo, Ireland
| | - Kenneth Monaghan
- Neuroplasticity Research Group, Clinical Health and Nutrition Centre (CHANCE), School of Science, Atlantic Technological University, Sligo, Ireland
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Ben-Shabat E, Morgan P. Assessing lesion location, visual midline perception and proprioception may assist outcome predictions for people affected by lateropulsion. Disabil Rehabil 2022; 45:1750-1751. [PMID: 36541185 DOI: 10.1080/09638288.2022.2156627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | - Prue Morgan
- School of Primary Health Care, Monash University, Frankston, Australia
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Embrechts E, van der Waal C, Anseeuw D, van Buijnderen J, Leroij A, Lafosse C, Nijboer TC, Truijen S, Saeys W. Association between spatial neglect and impaired verticality perception after stroke: A systematic review. Ann Phys Rehabil Med 2022; 66:101700. [PMID: 35963568 DOI: 10.1016/j.rehab.2022.101700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 07/01/2022] [Accepted: 07/02/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Although most research on spatial neglect (SN) has focused on spatial perception deficits with regard to the lateral (left-right) axis, deficits of spatial perception with regard to the vertical (up-down) axis, such as disturbances in the perception of verticality (e.g., judgement of vertical orientations), have also been suggested. OBJECTIVE We aimed to systematically analyse reported associations between SN and characteristics of verticality perception while considering the time post-stroke. METHODS PubMed, Web of Science, Scopus, PubPsych and PsycArticles databases were searched on May 24, 2022 for articles written in English that evaluated the association between SN and verticality perception (i.e., the subjective visual vertical [SVV], subjective postural vertical [SPV] and subjective haptic vertical [SHV]) in adults after stroke. Left and right SN were considered and had to be assessed using standardized methods. Data were manually extracted, and risk of bias was assessed with the Newcastle-Ottawa Scale. The tilt of the line/chair relative to the gravitational vector and its direction, together with uncertainty (i.e., variability across measurements), were evaluated. RESULTS Thirteen studies were included (431 participants after stroke); at least 191 participants exhibited SN. Mainly the first 3 to 6 months post-stroke were evaluated. SN was associated with SVV misperception, which resulted in larger SVV tilts (mostly in the contralesional direction) and uncertainty in participants with than without SN. SVV tilt magnitudes ranged from a mean/median of -8.9° to -2.3° in SN participants and from -1.6° to 0.6° in non-SN participants, the latter falling within normative ranges. For SPV and SHV measurements, the magnitude of tilt and the uncertainty were insufficiently assessed or results were inconclusive. CONCLUSIONS SN was associated with larger SVV tilts and uncertainty, which suggests that SVV misperception is a key feature of SN. This observation highlights the importance of regular SVV assessment in people with SN in clinical practice. PROSPERO CRD42019127616.
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Affiliation(s)
- Elissa Embrechts
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium; Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, the Netherlands.
| | - Charlotte van der Waal
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Dorine Anseeuw
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Jessica van Buijnderen
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Améline Leroij
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Christophe Lafosse
- Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
| | - Tanja Cw Nijboer
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, the Netherlands; Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Steven Truijen
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Wim Saeys
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium; Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
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Perceptual Biases as the Side Effect of a Multisensory Adaptive System: Insights from Verticality and Self-Motion Perception. Vision (Basel) 2022; 6:vision6030053. [PMID: 36136746 PMCID: PMC9502132 DOI: 10.3390/vision6030053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/22/2022] [Accepted: 08/04/2022] [Indexed: 11/17/2022] Open
Abstract
Perceptual biases can be interpreted as adverse consequences of optimal processes which otherwise improve system performance. The review presented here focuses on the investigation of inaccuracies in multisensory perception by focusing on the perception of verticality and self-motion, where the vestibular sensory modality has a prominent role. Perception of verticality indicates how the system processes gravity. Thus, it represents an indirect measurement of vestibular perception. Head tilts can lead to biases in perceived verticality, interpreted as the influence of a vestibular prior set at the most common orientation relative to gravity (i.e., upright), useful for improving precision when upright (e.g., fall avoidance). Studies on the perception of verticality across development and in the presence of blindness show that prior acquisition is mediated by visual experience, thus unveiling the fundamental role of visuo-vestibular interconnections across development. Such multisensory interactions can be behaviorally tested with cross-modal aftereffect paradigms which test whether adaptation in one sensory modality induces biases in another, eventually revealing an interconnection between the tested sensory modalities. Such phenomena indicate the presence of multisensory neural mechanisms that constantly function to calibrate self-motion dedicated sensory modalities with each other as well as with the environment. Thus, biases in vestibular perception reveal how the brain optimally adapts to environmental requests, such as spatial navigation and steady changes in the surroundings.
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13
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Argiuolo A, Somma F, Bartolomeo P, Gigliotta O, Ponticorvo M. Indexes for the E-Baking Tray Task: A Look on Laterality, Verticality and Quality of Exploration. Brain Sci 2022; 12:brainsci12030401. [PMID: 35326356 PMCID: PMC8946214 DOI: 10.3390/brainsci12030401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 12/01/2022] Open
Abstract
The Baking Tray Task is an ecological task developed for the assessment of unilateral neglect that can also be used for research on neurotypical participants. In this task, participants are asked to place 16 objects inside a board as evenly as possible. In the case of impaired spatial exploration, consequent to right attentional networks damage, asymmetrical object disposition is observed as more objects are placed on the ipsilesional side (typically the right side). The E-BTT is a technology-enhanced version of the Baking Tray Task, implemented with a software platform, E-TAN, which detects the objects and automatically computes their spatial coordinates. This allows a complement to the traditional scoring methods with new measures to extract richer information from the data. In this study, we focus on neurotypical participants to explore if some new indexes, derived from the literature review on similar tasks, can be applied to BTT and E-BTT for research aims. A principal component analysis (PCA) was then performed to verify if these new indexes reflect some common dimensions. Results indicate the emergence of two principal dimensions: spatiality, which summarizes both laterality and verticality, and quality, which regards the explored space and (dis)organization in placing the items.
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Affiliation(s)
- Antonietta Argiuolo
- Natural and Artificial Cognition Laboratory, Department of Humanistic Studies, University of Naples Federico II, 80133 Naples, Italy; (F.S.); (O.G.); (M.P.)
- Correspondence:
| | - Federica Somma
- Natural and Artificial Cognition Laboratory, Department of Humanistic Studies, University of Naples Federico II, 80133 Naples, Italy; (F.S.); (O.G.); (M.P.)
| | - Paolo Bartolomeo
- Institut du Cerveau—Paris Brain Institute—ICM, Inserm, Hôpital de la Pitié Salpêtrière, Sorbonne Université, 75013 Paris, France;
| | - Onofrio Gigliotta
- Natural and Artificial Cognition Laboratory, Department of Humanistic Studies, University of Naples Federico II, 80133 Naples, Italy; (F.S.); (O.G.); (M.P.)
| | - Michela Ponticorvo
- Natural and Artificial Cognition Laboratory, Department of Humanistic Studies, University of Naples Federico II, 80133 Naples, Italy; (F.S.); (O.G.); (M.P.)
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14
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Fukata K, Amimoto K, Inoue M, Sekine D, Fujino Y, Makita S, Takahashi H. Immediate effect of standing and sit-to-stand training on postural vertical for backward disequilibrium following stroke: a case report. Physiother Theory Pract 2022:1-9. [DOI: 10.1080/09593985.2022.2037031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Kazuhiro Fukata
- Department of Rehabilitation Center, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Kazu Amimoto
- Department of Physical Therapy, Faculty of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Masahide Inoue
- Department of Rehabilitation Center, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
- Department of Physical Therapy, Faculty of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Daisuke Sekine
- Department of Rehabilitation Center, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
- Department of Physical Therapy, Faculty of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Yuji Fujino
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan
| | - Shigeru Makita
- Department of Rehabilitation, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Hidetoshi Takahashi
- Department of Rehabilitation, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
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15
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Catanzariti JF, Coget M, Brouillard A. A perception bias of the gravitational vertical is confirmed in Adolescent Idiopathic Scoliosis. Spine Deform 2022; 10:69-78. [PMID: 34319559 DOI: 10.1007/s43390-021-00390-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 07/15/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Adolescent Idiopathic Scoliosis (AIS) is the most frequent spine deformity in adolescence. The cause of AIS remains unknown. Several studies show that AIS can be associated with a perception bias of gravitational vertical. In particularly, AIS patients with a right thoracic convexity exhibit deviation of the Subjective Postural Vertical. The origin of this disturbance could be located in trunk proprioceptive graciveptors. We wanted to verify this result with a population of lumbar and thoracolumbar AIS with left convexity. METHODS It was a multicenter, cross-sectional case-control study. Thirty adolescents with left lumbar or thoraco-lumbar AIS (age 14.3 ± 1.7 years; Cobb angle 27.6° ± 6.1°) and 30 controls matched for age (14.0 ± 1.5 years), were compared for Subjective Visual Vertical (SVV) measured in static and dynamic (optokinetic stimulation) conditions, and Subjective Postural Vertical (SPV). RESULTS For SVV, there was no difference in the two groups, for static and dynamic conditions. The SPV was significantly different between the two groups (p < 0.0001). The SPV was shifted to the left for most of the AIS patients (med - 2.4°[- 3.6; - 1.7]) compared with controls (med 0°[- 0.5; 1.7]). Adolescents with AIS perceived verticality with significant greater uncertainty in postural modality than controls (p = 0.017). CONCLUSION Our study confirms a significant directional bias in the orientation of SPV in left lumbar or thoraco-lumbar AIS. This confirmation paves the way to a new physiopathological model focused on trunk proprioception. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Jean-François Catanzariti
- Spine Department, SSR Pediatric Center Marc Sautelet, Villeneuve-d'Ascq, France. .,La Maison de la Scoliose, Villeneuve-d'Ascq, France.
| | - Monique Coget
- Spine Department, SSR Pediatric Center Marc Sautelet, Villeneuve-d'Ascq, France
| | - Anthony Brouillard
- Spine Department, SSR Pediatric Center Marc Sautelet, Villeneuve-d'Ascq, France.,La Maison de la Scoliose, Villeneuve-d'Ascq, France
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16
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Delle Monache S, Indovina I, Zago M, Daprati E, Lacquaniti F, Bosco G. Watching the Effects of Gravity. Vestibular Cortex and the Neural Representation of "Visual" Gravity. Front Integr Neurosci 2021; 15:793634. [PMID: 34924968 PMCID: PMC8671301 DOI: 10.3389/fnint.2021.793634] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
Gravity is a physical constraint all terrestrial species have adapted to through evolution. Indeed, gravity effects are taken into account in many forms of interaction with the environment, from the seemingly simple task of maintaining balance to the complex motor skills performed by athletes and dancers. Graviceptors, primarily located in the vestibular otolith organs, feed the Central Nervous System with information related to the gravity acceleration vector. This information is integrated with signals from semicircular canals, vision, and proprioception in an ensemble of interconnected brain areas, including the vestibular nuclei, cerebellum, thalamus, insula, retroinsula, parietal operculum, and temporo-parietal junction, in the so-called vestibular network. Classical views consider this stage of multisensory integration as instrumental to sort out conflicting and/or ambiguous information from the incoming sensory signals. However, there is compelling evidence that it also contributes to an internal representation of gravity effects based on prior experience with the environment. This a priori knowledge could be engaged by various types of information, including sensory signals like the visual ones, which lack a direct correspondence with physical gravity. Indeed, the retinal accelerations elicited by gravitational motion in a visual scene are not invariant, but scale with viewing distance. Moreover, the "visual" gravity vector may not be aligned with physical gravity, as when we watch a scene on a tilted monitor or in weightlessness. This review will discuss experimental evidence from behavioral, neuroimaging (connectomics, fMRI, TMS), and patients' studies, supporting the idea that the internal model estimating the effects of gravity on visual objects is constructed by transforming the vestibular estimates of physical gravity, which are computed in the brainstem and cerebellum, into internalized estimates of virtual gravity, stored in the vestibular cortex. The integration of the internal model of gravity with visual and non-visual signals would take place at multiple levels in the cortex and might involve recurrent connections between early visual areas engaged in the analysis of spatio-temporal features of the visual stimuli and higher visual areas in temporo-parietal-insular regions.
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Affiliation(s)
- Sergio Delle Monache
- UniCamillus—Saint Camillus International University of Health Sciences, Rome, Italy
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Iole Indovina
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Myrka Zago
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
- Center for Space Biomedicine, University of Rome “Tor Vergata”, Rome, Italy
- Department of Civil and Computer Engineering, University of Rome “Tor Vergata”, Rome, Italy
| | - Elena Daprati
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
- Center for Space Biomedicine, University of Rome “Tor Vergata”, Rome, Italy
- Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Francesco Lacquaniti
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
- Center for Space Biomedicine, University of Rome “Tor Vergata”, Rome, Italy
- Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Gianfranco Bosco
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
- Center for Space Biomedicine, University of Rome “Tor Vergata”, Rome, Italy
- Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
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17
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Ferreira LR, Ferreira FJPDA, Campos FA, Luvizutto GJ, Souza LAPSD. Evaluation of subjective vertical perception among stroke patients: a systematic review. ARQUIVOS DE NEURO-PSIQUIATRIA 2021; 79:1026-1034. [PMID: 34816993 DOI: 10.1590/0004-282x-anp-2020-0584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/25/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Verticality misperception is relatively common among patients after stroke, and it may be evaluated in terms of (a) subjective visual vertical (SVV), (b) subjective haptic vertical (SHV) and (c) subjective postural vertical (SPV). To better understand these assessment methods, we conducted a systematic review of the methodological characteristics of different protocols for evaluating SVV, SHV and SPV among individuals after stroke. OBJECTIVE To standardize the methodological characteristics of protocols for evaluating verticality perception after stroke. METHODS We searched the following databases: PUBMED, regional BVS portal (MEDLINE, LILACS, IBECS, CUBMED, Psychology Index and LIS), CINAHL, SCOPUS, Web of Science, Science Direct, Cochrane Library and PEDro. Two review authors independently used the QUADAS method (Quality Assessment of Diagnostic Accuracy Studies) and extracted data. RESULTS We included 21 studies in the review: most (80.9%) used SVV, eight (38.1%) used SPV and four (19.0%) used SHV. We observed high variability in assessments of verticality perception, due to patient positions, devices used, numbers of repetitions and angle of inclination for starting the tests. CONCLUSION This systematic review was one of the first to explore all the methods of assessing verticality perception after stroke, and it provides crucial information on how to perform the tests, in order to guide future researchers/clinicians.
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Affiliation(s)
| | | | | | - Gustavo José Luvizutto
- Universidade Federal do Triângulo Mineiro, Departamento de Fisioterapia Aplicada, Uberaba MG, Brazil
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18
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Matsuo H, Kubota M, Matsumura M, Takayama M, Mae Y, Kitazaki Y, Enomoto S, Ueno A, Ikawa M, Hamano T, Takahashi A, Tsubokawa M, Shimada S. Center of pressure velocities in patients with body lateropulsion: three case report series of Wallenberg's syndrome. Physiother Theory Pract 2021; 38:3264-3272. [PMID: 34661499 DOI: 10.1080/09593985.2021.1990448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE In patients with Wallenberg's syndrome who present with body lateropulsion (BL), whether the center of pressure (COP) position and velocity characterize postural dysregulation is unknown. We measured time-course changes in COP parameters in three BL patients. METHODS Three patients with acute Wallenberg's syndrome presented with BL. COP was measured for time-course changes during first standing and every week thereafter. COP positions, which indicate the deviation in the center of gravity, were calculated. COP velocities associated with dynamic movements of the center of gravity were analyzed separately for the BL and non-BL sides. RESULTS All patients showed that COP position shifted to the BL side in first standing and changed to the center over time. COP velocities to the BL side were fast in first standing. Two of the three patients had significantly faster COP velocities to the BL side than to the non-BL side (p < .05), and one did not. In all three cases, the faster COP velocities to the BL side decreased significantly after 2 weeks compared to the initial standing position (p < .001). The change seemed to be related to the time when independent walking became possible. CONCLUSIONS Fast COP velocity to the BL side might reflect postural dysregulation in patients with BL. These findings might be useful information for devising effective rehabilitation in patients with BL.
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Affiliation(s)
- Hideaki Matsuo
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
| | - Masafumi Kubota
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
| | - Mayumi Matsumura
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
| | - Mami Takayama
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
| | - Yuri Mae
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
| | - Yuki Kitazaki
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Soichi Enomoto
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Asako Ueno
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Masamichi Ikawa
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Tadanori Hamano
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Ai Takahashi
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan.,Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Misao Tsubokawa
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan.,Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Seiichiro Shimada
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
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19
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Piscicelli C, Castrioto A, Jaeger M, Fraix V, Chabardes S, Moro E, Krack P, Debû B, Pérennou D. Contribution of Basal Ganglia to the Sense of Upright: A Double-Blind Within-Person Randomized Trial of Subthalamic Stimulation in Parkinson's Disease with Pisa Syndrome. JOURNAL OF PARKINSONS DISEASE 2021; 11:1393-1408. [PMID: 33896847 DOI: 10.3233/jpd-202388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Verticality perception is frequently altered in Parkinson's disease (PD) with Pisa syndrome (PS). Is it the cause or the consequence of the PS? OBJECTIVE We tested the hypothesis that both scenarios coexist. METHODS We performed a double-blind within-person randomized trial (NCT02704910) in 18 individuals (median age 63.5 years) with PD evolving for a median of 17.5 years and PS for 2.5 years and treated with bilateral stimulation of the subthalamus nuclei (STN-DBS) for 6.5 years. We analyzed whether head and trunk orientations were congruent with the visual (VV) and postural (PV) vertical, and whether switching on one or both sides of the STN-DBS could modulate trunk orientation via verticality representation. RESULTS The tilted verticality perception could explain the PS in 6/18 (33%) patients, overall in three right-handers (17%) who showed net and congruent leftward trunk and PV tilts. Two of the 18 (11%) had an outstanding clinical picture associating leftward: predominant parkinsonian symptoms, whole-body tilt (head -11°, trunk -8°) and transmodal tilt in verticality perception (PV -10°, VV -8.9°). Trunk orientation or VV were not modulated by STN-DBS, whereas PV tilts were attenuated by unilateral or bilateral stimulations if it was applied on the opposite STN. CONCLUSION In most cases of PS, verticality perception is altered by the body deformity. In some cases, PS seems secondary to a biased internal model of verticality, and DBS on the side of the most denervated STN attenuated PV tilts with a quasi-immediate effect. This is an interesting track for further clinical studies.
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Affiliation(s)
- Céline Piscicelli
- Department of NeuroRehabilitation, Grenoble-Alpes University Hospital, Grenoble, France.,Lab Cognitive Neurosciences CNRS-UMR5105 (LPNC), University Grenoble-Alpes, Grenoble, France
| | - Anna Castrioto
- Grenoble Institute Neurosciences (GIN), Grenoble-Alpes University Hospital, University Grenoble-Alpes, Inserm, U1216, Grenoble, France
| | - Marie Jaeger
- Department of NeuroRehabilitation, Grenoble-Alpes University Hospital, Grenoble, France
| | - Valerie Fraix
- Grenoble Institute Neurosciences (GIN), Grenoble-Alpes University Hospital, University Grenoble-Alpes, Inserm, U1216, Grenoble, France
| | - Stephan Chabardes
- Department of Neurosurgery, Grenoble-Alpes University Hospital, Grenoble, France
| | - Elena Moro
- Grenoble Institute Neurosciences (GIN), Grenoble-Alpes University Hospital, University Grenoble-Alpes, Inserm, U1216, Grenoble, France
| | - Paul Krack
- Movement Disorders Center, Department of Neurology, University Hospital (Inselspital) and University of Bern, Bern, Switzerland
| | - Bettina Debû
- Grenoble Institute Neurosciences (GIN), Grenoble-Alpes University Hospital, University Grenoble-Alpes, Inserm, U1216, Grenoble, France
| | - Dominic Pérennou
- Department of NeuroRehabilitation, Grenoble-Alpes University Hospital, Grenoble, France.,Lab Cognitive Neurosciences CNRS-UMR5105 (LPNC), University Grenoble-Alpes, Grenoble, France
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20
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Nedelkou A, Hatzitaki V, Chatzinikolaou K, Grouios G. Does somatosensory feedback from the plantar foot sole contribute to verticality perception? Somatosens Mot Res 2021; 38:214-222. [PMID: 34256655 DOI: 10.1080/08990220.2021.1949977] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM OF THE STUDY In upright standing, the human foot sole is the only point of contact with the ground conveying information about the pressure distribution under the feet. We examined how the altered somatosensory input from the plantar foot receptors, when standing on a soft surface, affects the subjective estimation of the earth vertical in different sensory contexts. MATERIALS AND METHODS Twelve (12) healthy young females (mean age: 21.8 ± 2.4 years) adjusted the orientation of a visual line (35 × 1.5 cm) representing the roll orientation of a hand-held (attached on a 24.9 × 4 cm cylinder) or head-attached electromagnetic tracking sensor (Nest of Birds, Ascension Technologies Inc., VT. USA, 60 Hz) under two visual conditions (eyes open, eyes closed) while standing on a soft or firm surface. The mean absolute (accuracy) and variable (precision) error in the verticality estimate was depicted in the sensor's roll deviation from the gravitational vertical. RESULTS The accuracy and the precision of the estimate decreased in the absence of vision, while standing on the soft surface and when the estimate was provided by an active hand rather than head rotation. The surface effect was significant only in the absence of vision and when the estimate was provided by the hand. CONCLUSIONS The contribution of the plantar foot mechanoreceptors to gravity perception is sensory context dependent. Perception of the earth vertical is more accurate when estimated by active head rotation due to the integration of the vestibular and neck proprioceptive afferents.
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Affiliation(s)
- A Nedelkou
- Laboratory of Motor Behavior and Adapted Physical Activity, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - V Hatzitaki
- Laboratory of Motor Behavior and Adapted Physical Activity, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - K Chatzinikolaou
- Laboratory of Motor Behavior and Adapted Physical Activity, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - G Grouios
- Laboratory of Motor Behavior and Adapted Physical Activity, Aristotle University of Thessaloniki, Thessaloniki, Greece
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21
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Riera-Tur L, Caballero-Garcia A, Martin-Mateos AJ, Lechuga-Sancho AM. Efficacy of the subjective visual vertical test performed using a mobile application to detect vestibular pathology. J Vestib Res 2021; 32:21-27. [PMID: 34180441 DOI: 10.3233/ves-201526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The subjective visual vertical (SVV) test is a sensitive test of vestibular dysfunction that allows the evaluation of otolithic organs; however, with the current method, there are technical and logistical limitations that make the application of this test difficult in the conventional clinic. OBJECTIVE The objective of this study is to assess the effectiveness of detecting vestibular pathology using the SVV via a new screening method. METHODS A consecutive sample of 62 patients with suspected vestibular pathology was included in the study. The patients were clinically diagnosed according to the Barany Society criteria. An exploratory system was designed using a mobile application in Android that detects accelerometer oscillations and involves placing the smartphone on a rotating disk anchored to the wall. All patients underwent a SVV examination using the bucket method and the study test. A cut-off point of the ROC curve was calculated for each test, and its sensitivity, specificity, diagnostic accuracy and probability ratios for detecting vestibular pathology were analysed. The SVV results were compared using the bucket test and the study test. RESULTS We observed significant differences in sensitivity between the two tests: 86.95% for the study test versus 67.4% for the bucket test (p < 0.01). In the ROC curve, an area under the curve of 0.90 was observed for the study test, with a cut-off of 2.43 for a sensitivity of 86.95% and a specificity of 93.75%. CONCLUSIONS SVV testing using a smartphone placed on a rotating disk anchored to the wall offers greater diagnostic accuracy than SVV using the bucket test. Both methods are inexpensive, harmless and easily accepted by patients.
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Affiliation(s)
- Laura Riera-Tur
- Department of Otolaryngology, Puerta del Mar University Hospital, Cádiz, Spain. Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
| | - Andres Caballero-Garcia
- Department of Otolaryngology, Puerta del Mar University Hospital, Cádiz, Spain. Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
| | - Antonio J Martin-Mateos
- Department of Otolaryngology, Puerta del Mar University Hospital, Cádiz, Spain. Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
| | - Alfonso M Lechuga-Sancho
- Department of Child and Mother Health and Radiology, Medical School, University of Cádiz, Cádiz, Spain. Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
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22
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Nolan J, Godecke E, Spilsbury K, Singer B. Post-stroke lateropulsion and rehabilitation outcomes: a retrospective analysis. Disabil Rehabil 2021; 44:5162-5170. [PMID: 34038657 DOI: 10.1080/09638288.2021.1928300] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE A person with post-stroke lateropulsion actively pushes themselves toward their hemiplegic side, or resists moving onto their non-hemiplegic side. This study aimed to determine the association of lateropulsion severity with: • Change in function (Functional Independence Measure - FIM) and lateropulsion severity (Four-Point Pusher Score - 4PPS) during inpatient rehabilitation; • Inpatient rehabilitation length of stay (LOS); • Discharge destination from inpatient rehabilitation. METHODS Retrospective data for 1,087 participants (aged ≥65 years) admitted to a stroke rehabilitation unit (2005-2018) were analysed using multivariable regression models. RESULTS Complete resolution of lateropulsion was seen in 69.4% of those with mild lateropulsion on admission (n = 160), 49.3% of those with moderate lateropulsion (n = 142), and 18.8% of those with severe lateropulsion (n = 181). Average FIM change was lower in those with severe lateropulsion on admission than those with no lateropulsion (p < 0.001). Higher admission 4PPS was associated with reduced FIM efficiency (p < 0.001), longer LOS (p < 0.001), (adjusted mean LOS: 35.6 days for those with severe lateropulsion versus 27.0 days for those without), and reduced likelihood of discharge home (p < 0.001). CONCLUSION Post-stroke lateropulsion is associated with reduced functional improvement and likelihood of discharge home. However, given a longer rehabilitation duration, most stroke survivors with moderate to severe lateropulsion can achieve important functional improvement.Implications for RehabilitationWhile people with post-stroke lateropulsion can be difficult to treat and require more resources than those without lateropulsion, the majority of those affected, even in severe cases, can make meaningful recovery with appropriate rehabilitation.Although those with moderate to severe post-stroke lateropulsion may have poorer outcomes (longer LOS and reduced likelihood of discharge home) it is still important to advocate for access to rehabilitation for this patient group to give them the opportunity for optimal functional recovery.
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Affiliation(s)
- Jessica Nolan
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.,Osborne Park Hospital, Stirling, Australia
| | - Erin Godecke
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.,Sir Charles Gairdner Hospital, Nedlands, Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Australia
| | - Katrina Spilsbury
- Institute for Health Research, University of Notre Dame Australia, Fremantle, Australia
| | - Barbara Singer
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.,Training Centre in Subacute Care, South Metropolitan Health Service, Fremantle Hospital, Fremantle, Australia
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23
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Nakamura A, Suzuki Y, Milosevic M, Nomura T. Long-Lasting Event-Related Beta Synchronizations of Electroencephalographic Activity in Response to Support-Surface Perturbations During Upright Stance: A Pilot Study Associating Beta Rebound and Active Monitoring in the Intermittent Postural Control. Front Syst Neurosci 2021; 15:660434. [PMID: 34093142 PMCID: PMC8175801 DOI: 10.3389/fnsys.2021.660434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/29/2021] [Indexed: 11/13/2022] Open
Abstract
Movement related beta band cortical oscillations, including beta rebound after execution and/or suppression of movement, have drawn attention in upper extremity motor control literature. However, fewer studies focused on beta band oscillations during postural control in upright stance. In this preliminary study, we examined beta rebound and other components of electroencephalogram (EEG) activity during perturbed upright stance to investigate supraspinal contributions to postural stabilization. Particularly, we aimed to clarify the timing and duration of beta rebound within a non-sustained, but long-lasting postural recovery process that occurs more slowly compared to upper extremities. To this end, EEG signals were acquired from nine healthy young adults in response to a brief support-surface perturbation, together with the center of pressure, the center of mass and electromyogram (EMG) activities of ankle muscles. Event-related potentials (ERPs) and event-related spectral perturbations were computed from EEG data using the perturbation-onset as a triggering event. After short-latency (<0.3 s) ERPs, our results showed a decrease in high-beta band oscillations (event-related desynchronization), which was followed by a significant increase (event-related synchronization) in the same band, as well as a decrease in theta band oscillations. Unlike during upper extremity motor tasks, the beta rebound in this case was initiated before the postural recovery was completed, and sustained for as long as 3 s with small EMG responses for the first half period, followed by no excessive EMG activities for the second half period. We speculate that those novel characteristics of beta rebound might be caused by slow postural dynamics along a stable manifold of the unstable saddle-type upright equilibrium of the postural control system without active feedback control, but with active monitoring of the postural state, in the framework of the intermittent control.
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Affiliation(s)
| | | | | | - Taishin Nomura
- Department of Mechanical Science and Bioengineering, Graduate School of Engineering Science, Osaka University, Osaka, Japan
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24
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Nolan J, Godecke E, Singer B. The association between contraversive lateropulsion and outcomes post stroke: A systematic review. Top Stroke Rehabil 2021; 29:92-102. [PMID: 33648434 DOI: 10.1080/10749357.2021.1886640] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: Contraversive lateropulsion is a common post-stroke impairment. Rehabilitation outcomes in stroke survivors exhibiting lateropulsion may differ from those without lateropulsion.Objectives: To systematically review evidence regarding associations between:1. Presence/severity of lateropulsion after stroke and functional outcome, rehabilitation length of stay, and discharge destination;2. Stroke-related factors and resolution of lateropulsion, functional outcome, rehabilitation length of stay, and discharge destination in affected stroke survivors.Methods: Medline, CINAHL, and Embase databases were searched. Journal articles published in English reporting on resolution of lateropulsion, length of stay, functional outcome, and/or discharge destination associated with post-stroke lateropulsion were included for review. Studies that did not include a comparison group (stroke survivors without lateropulsion, or sub-groups of participants with lateropulsion based on stroke-related factors), animal studies, and studies reporting only on ipsiversive lateropulsion and/or lateral medullary syndrome were excluded. Two authors independently assessed studies for inclusion. Included studies were evaluated using the Risk of Bias Assessment Tool for Nonrandomized Studies.Results: Screening identified 133 articles. Seven articles met inclusion criteria. People with contraversive lateropulsion after stroke can achieve similar improvements in function as those without lateropulsion, increasing likelihood of discharge home, but require longer rehabilitation durations to do so.Conclusions: The finding that longer rehabilitation durations are required for people with post-stroke lateropulsion to achieve their functional potential and increase likelihood of discharge home has implications for resourcing rehabilitation services. Given an additional three to four weeks in rehabilitation, people with post-stroke lateropulsion can achieve functional improvements function similar to those without lateropulsion.
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Affiliation(s)
- Jessica Nolan
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australian.,Physiotherapy Department, Osborne Park Hospital, Stirling, Western Australia, Australian
| | - Erin Godecke
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australian.,Speech Pathology Department, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australian.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
| | - Barbara Singer
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australian.,Western Australian Department of Health, Training Centre in Subacute Care WA, Fremantle, Western Australia, Australia
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25
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Rodríguez-Almagro D, Obrero-Gaitán E, Lomas-Vega R, Zagalaz-Anula N, Osuna-Pérez MC, Achalandabaso-Ochoa A. New Mobile Device to Measure Verticality Perception: Results in Young Subjects with Headaches. Diagnostics (Basel) 2020; 10:E796. [PMID: 33036468 PMCID: PMC7601549 DOI: 10.3390/diagnostics10100796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/30/2020] [Accepted: 10/02/2020] [Indexed: 02/07/2023] Open
Abstract
The subjective visual vertical (SVV) test has been frequently used to measure vestibular contribution to the perception of verticality. Recently, mobile devices have been used to efficiently perform this measurement. The aim of this study was to analyze the perception of verticality in subjects with migraines and headaches. A cross-sectional study was conducted that included 28 patients with migraine, 74 with tension-type headache (TTH), and 93 healthy subjects. The SVV test was used through a new virtual reality system. The mean absolute error (MAE) of degrees deviation was also measured to qualify subjects as positive when it was greater than 2.5°. No differences in the prevalence of misperception in verticality was found among healthy subjects (31.18%), migraineurs (21.43%), or those with TTH (33.78%) (p = 0.480). The MAE was not significantly different between the three groups (migraine = 1.36°, TTH = 1.61°, and healthy = 1.68°) (F = 1.097, p = 0.336, and η2 = 0.011). The perception of verticality could not be explained by any variable usually related to headaches. No significant differences exist in the vestibular contribution to the perception of verticality between patients with headaches and healthy subjects. New tests measuring visual and somatosensory contribution should be used to analyze the link between the perception of verticality and headaches.
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Affiliation(s)
| | | | - Rafael Lomas-Vega
- Department of Health Science, University of Jaén, Paraje Las Lagunillas s/n, 23071 Jaén, Spain; (D.R.-A.); (E.O.-G.); (N.Z.-A.); (M.C.O.-P.); (A.A.-O)
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26
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Obrero-Gaitán E, Manrique-Navarro M, Lérida-Ortega MÁ, Rodríguez-Almagro D, Osuna-Pérez MC, Lomas-Vega R. Misperception of Visual Verticality in Patients with Primary Headache Disorders: A Systematic Review with Meta-Analysis. Brain Sci 2020; 10:brainsci10100664. [PMID: 32987639 PMCID: PMC7598580 DOI: 10.3390/brainsci10100664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/16/2020] [Accepted: 09/22/2020] [Indexed: 02/07/2023] Open
Abstract
Migraine and tension-type headache (TTH) are the two most prevalent primary headache disorders (PHDs) that may involve visual and vestibular impairments, neck pain, and postural unsteadiness. The perception of visual verticality (VV) has been studied in patients diagnosed with PHD to assess balance disorders showing varying findings. Our study aimed to assess the VV perception in patients diagnosed with PHD in comparison to healthy controls. A systematic review with meta-analysis was carried out in PubMed MEDLINE, Scopus, WOS, CINAHL, and SciELO. The Cohen standardized mean difference (SMD) was used to estimate the differences between exposed and healthy controls. Seven studies with 816 participants were included. The quality of included studies, according to the Newcastle–Ottawa Scale (NOS), was moderate (mean score of 5.2). Patients diagnosed with PHD showed a moderate misperception of VV as assessed with the subjective visual vertical (SVV) test (SMD = 0.530; 95% CI = 0.225, 0.836; p < 0.001). Specifically, a misperception of the SVV was found in patients with migraine (SMD = 0.369; 95% CI = 0.1, 0.638; p = 0.007) and with TTH (SMD = 1.122; 95% CI = 0.540, 1.704; p < 0.001). This review shows a misperception of VV in patients with migraine and TTH when assessed with the SVV test, being higher in patients with TTH, although the THH sample size was low.
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Affiliation(s)
- Esteban Obrero-Gaitán
- Department of Health Sciences, University of Jaen, 23071 Jaen, Spain; (E.O.-G.); (M.Á.L.-O.); (M.C.O.-P.); (R.L.-V.)
| | | | - Miguel Ángel Lérida-Ortega
- Department of Health Sciences, University of Jaen, 23071 Jaen, Spain; (E.O.-G.); (M.Á.L.-O.); (M.C.O.-P.); (R.L.-V.)
- Hospital San Agustín de Linares, 23700 Linares, Spain
- Escuela de Osteopatía de Madrid S.L., 28807 Alcalá de Henares, Madrid, Spain
| | - Daniel Rodríguez-Almagro
- Department of Health Sciences, University of Jaen, 23071 Jaen, Spain; (E.O.-G.); (M.Á.L.-O.); (M.C.O.-P.); (R.L.-V.)
- Correspondence: ; Tel.: +34-953-212-381
| | - María Catalina Osuna-Pérez
- Department of Health Sciences, University of Jaen, 23071 Jaen, Spain; (E.O.-G.); (M.Á.L.-O.); (M.C.O.-P.); (R.L.-V.)
| | - Rafael Lomas-Vega
- Department of Health Sciences, University of Jaen, 23071 Jaen, Spain; (E.O.-G.); (M.Á.L.-O.); (M.C.O.-P.); (R.L.-V.)
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27
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Obrero-Gaitán E, Molina F, Del-Pino-Casado R, Ibáñez-Vera AJ, Rodríguez-Almagro D, Lomas-Vega R. Visual Verticality Perception in Spinal Diseases: A Systematic Review and Meta-Analysis. J Clin Med 2020; 9:E1725. [PMID: 32503240 PMCID: PMC7356295 DOI: 10.3390/jcm9061725] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 12/26/2022] Open
Abstract
Patients diagnosed with traumatic or non-traumatic spinal pain and idiopathic scoliosis frequently suffer from imbalance. The evaluation of the perception of verticality by means of visual tests emerges as a quick and easy tool for clinical management of the balance disorders. Several studies have assessed the visual perception of verticality in spinal diseases obtaining controversial results. The aim of our study is to analyze the perception of visual verticality in subjects with several spinal diseases in comparison with healthy subjects. A meta-analysis was carried out. PubMed MEDLINE, Scopus, WoS, CINAHL, and SciELO databases were searched until January 2020. The standardized mean difference (SMD) was calculated to analyze differences between patients and healthy controls. Fifteen studies with a total of 2052 patients were included. In comparison with healthy subjects, a misperception of verticality was found in patients with spinal pain when the perception of the verticality was assessed with the rod and frame test (SMD = 0.339; 95% confidence interval (CI) = 0.181, 0.497; p < 0.001). It seems that the perception of visual verticality is not altered in patients with idiopathic scoliosis (p = 0.294). The present meta-analysis shows a misperception of visual verticality only in patients with spinal pain.
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Affiliation(s)
- Esteban Obrero-Gaitán
- Department of Health Sciences, University of Jaén, Paraje Las Lagunillas s/n, 23071 Jaén, Spain; (E.O.-G.); (A.J.I.-V.); (D.R.-A.); (R.L.-V.)
| | - Francisco Molina
- Department of Health Sciences, University of Jaén, Paraje Las Lagunillas s/n, 23071 Jaén, Spain; (E.O.-G.); (A.J.I.-V.); (D.R.-A.); (R.L.-V.)
| | - Rafael Del-Pino-Casado
- Department of Nursing, University of Jaén, Paraje Las Lagunillas s/n, 23071 Jaén, Spain;
| | - Alfonso Javier Ibáñez-Vera
- Department of Health Sciences, University of Jaén, Paraje Las Lagunillas s/n, 23071 Jaén, Spain; (E.O.-G.); (A.J.I.-V.); (D.R.-A.); (R.L.-V.)
| | - Daniel Rodríguez-Almagro
- Department of Health Sciences, University of Jaén, Paraje Las Lagunillas s/n, 23071 Jaén, Spain; (E.O.-G.); (A.J.I.-V.); (D.R.-A.); (R.L.-V.)
| | - Rafael Lomas-Vega
- Department of Health Sciences, University of Jaén, Paraje Las Lagunillas s/n, 23071 Jaén, Spain; (E.O.-G.); (A.J.I.-V.); (D.R.-A.); (R.L.-V.)
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Immersive Virtual Reality in Stroke Patients as a New Approach for Reducing Postural Disabilities and Falls Risk: A Case Series. Brain Sci 2020; 10:brainsci10050296. [PMID: 32429085 PMCID: PMC7287864 DOI: 10.3390/brainsci10050296] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/06/2020] [Accepted: 05/13/2020] [Indexed: 12/16/2022] Open
Abstract
Stroke is a neurologic disorder considered the first cause of disability worldwide due to motor, cognitive, and sensorial sequels. Balance dysfunctions in stroke survivors increase the risk of falls and physiotherapeutic rehabilitation is essential to reduce it. Virtual reality (VR) seems to be an alternative to conventional physiotherapy (CT), providing virtual environments and multisensorial inputs to train balance in stroke patients. The aim of this study was to assess if immersive VR treatment is more effective than CT to improve balance after stroke. This study got the approval from the Ethics Committee of the University of Almeria. Three chronic ischemic stroke patients were selected. One patient who received 25 sessions of immersive VR intervention for two months was compared with another patient who received equivalent CT and a third patient with no intervention. Balance, gait, risk of falling, and vestibular and visual implications in the equilibrium were assessed. After the interventions, the two patients receiving any of the treatments showed an improvement in balance compared to the untreated patient. In comparison to CT, our results suggest a higher effect of immersive VR in the improvement of balance and a reduction of falls risk due to the active upright work during the VR intervention.
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29
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Ukita A, Abe M, Kishigami H, Hatta T. Influence of back support shape in wheelchairs offering pelvic support on asymmetrical sitting posture and pressure points during reaching tasks in stroke patients. PLoS One 2020; 15:e0231860. [PMID: 32315353 PMCID: PMC7173851 DOI: 10.1371/journal.pone.0231860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 04/02/2020] [Indexed: 12/25/2022] Open
Abstract
Many poststroke hemiplegic patients have an asymmetrical wheelchair-sitting posture. This study aimed to investigate the impact of different back support shapes on asymmetrical sitting posture and pressure points among poststroke hemiplegic patients during an activities of daily living–related reaching task. This study included 23 poststroke hemiplegic patients who performed tasks that involved the movement of objects using the unaffected upper limb to the affected side while sitting in a conventional wheelchair (C-WC) with a flat back support or a wheelchair providing pelvic and thoracic support (P-WC). Body alignment angles from video images and pressure distribution on supporting surfaces were measured using a two-dimensional motion analysis software (Dartfish) and a pressure mapping system (FSA). Regarding movement performance, although postural asymmetry increased in both wheelchair types, the degree of postural variation was smaller with P-WC use than C-WC use (p < 0.05), with partly reduced postural asymmetry. With P-WC, one-sided ischial asymmetrical pressure was significantly less after the movement (p < 0.05). In conclusion, P-WC’s back support shape contributed to a decrease in postural asymmetry for pelvic girdle support both at rest and during movement. This highlights the importance of a wheelchair back support shape and may help to increase the quality of activities of daily living movement in poststroke hemiplegic patients in wheelchairs.
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Affiliation(s)
- Atsuki Ukita
- Social Medical Corporation Hokuto, Tokachi Rehabilitation Center, Obihiro, Japan
- Tohoku Fukushi University, Sendai, Japan
| | - Masayuki Abe
- Social Medical Corporation Hokuto, Tokachi Rehabilitation Center, Obihiro, Japan
| | | | - Tatsuo Hatta
- Japan Health Care College, Eniwa, Japan
- * E-mail:
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30
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Jamal K, Leplaideur S, Rousseau C, Cordillet S, Raillon AM, Butet S, Cretual A, Bonan I. The effects of repetitive neck-muscle vibration on postural disturbances after a chronic stroke. Neurophysiol Clin 2020; 50:269-278. [PMID: 32245547 DOI: 10.1016/j.neucli.2020.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 01/22/2020] [Accepted: 01/22/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE We aimed to test a repeated program of vibration sessions of the neck muscles (rNMV) on postural disturbances and spatial perception in patients with right (RBD) versus left (LBD) vascular brain damage. METHODS Thirty-two chronic stroke patients (mean age 60.9±10 yrs and mean time since stroke 4.9±4 yrs), 16 RBD and 16 LBD, underwent a program of 10 sessions of NMV over two weeks. Posturography parameters (weight-bearing asymmetry (WBA), Xm, Ym, and surface), balance rating (Berg Balance Scale (BBS), Timed Up and Go (TUG)), space representation (subjective straight ahead (SSA), longitudinal body axis (LBA), subjective visual vertical (SVV)), and post-stroke deficiencies (motricity index, sensitivity, and spasticity) were tested and the data analyzed by ANOVA or a linear rank-based model, depending on whether the data were normally distributed, with lesion side and time factor (D-15, D0, D15, D21, D45). RESULTS The ANOVA revealed a significant interaction between lesion side and time for WBA (P<0.0001) with a significant shift towards the paretic lower limb in the RBD patients only (P=0.0001), whereas there was no effect in the LBD patients (P=0.98). Neither group showed a significant modification of spatial representation. Nonetheless, there was a significant improvement in motricity (P=0.02), TUG (P=0.0005), and BBS (P<0.0001) in both groups at the end of treatment and afterwards. CONCLUSIONS rNMV appeared to correct WBA in RBD patients only. This suggests that rNMV could be effective in treating sustainable imbalance due to spatial cognition disorders.
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Affiliation(s)
- Karim Jamal
- Physical and Rehabilitation Medicine Department, University Hospital of Rennes, Rennes, France; M2S laboratory-EA 1274, University of Rennes 2, Rennes, France.
| | - Stéphanie Leplaideur
- Physical and Rehabilitation Medicine Department, University Hospital of Rennes, Rennes, France; Neurology Physical and Rehabilitation Medicine Department, CMRRF KERPAPE, France; Unit EMPENN, INSERM, INRIA, Unit 1228 University Rennes 1, Rennes, France
| | - Chloé Rousseau
- Department of Clinical Pharmacology, Clinical Investigation, Center INSERM 1414, University Hospital of Rennes, Rennes, France
| | - Sébastien Cordillet
- Physical and Rehabilitation Medicine Department, University Hospital of Rennes, Rennes, France
| | - Annelise Moulinet Raillon
- Physical and Rehabilitation Medicine Department, University Hospital of Rennes, Rennes, France; Physical and rehabilitation medicine department, Hospital of Saint-Vallier, Saint-Vallier, France
| | - Simon Butet
- Physical and Rehabilitation Medicine Department, University Hospital of Rennes, Rennes, France
| | - Armel Cretual
- M2S laboratory-EA 1274, University of Rennes 2, Rennes, France
| | - Isabelle Bonan
- Physical and Rehabilitation Medicine Department, University Hospital of Rennes, Rennes, France; M2S laboratory-EA 1274, University of Rennes 2, Rennes, France
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31
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Yeo SS, Jang SH, Oh S, Kwon JW. Role of diffusion tensor imaging in analyzing the neural connectivity of the parieto-insular vestibular cortex in pusher syndrome: As case report. Medicine (Baltimore) 2020; 99:e19835. [PMID: 32312005 PMCID: PMC7220494 DOI: 10.1097/md.0000000000019835] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Pusher syndrome is a disorder of postural control. It is associated with unilateral lesions on central vestibular system. In the current study, we attempted to identify and investigate neural connectivity of the parieto-insular vestibular cortex in a patient with pusher syndrome, using diffusion tensor imaging. PATIENT CONCERNS A 60-year-old male patient had left hemiplegia due to an infarction on right premotor cortex, primary motor cortex, corona radiata and temporal and occipital lobe. The patient had severe motor weakness in left upper and lower limb, left side neglect and significant pusher syndrome. DIAGNOSIS Patient was diagnosed with left hemiplegia due to an infarction in the right middle cerebral artery territory at the neurology department of a university hospital. INTERVENTIONS One patient and 5 control subjects of similar age participated. Diffusion tensor imaging data were acquired at 4-month and 12-month after the initial injury. OUTCOMES Fractional anisotropy, mean diffusivity, and tract volume (TV) were measured. TV values in both affected and unaffected hemispheres of the patient were significantly decreased at 4-month compared to those of control subjects. In the unaffected hemisphere of the patient, TV value showed significant increase at 12-month compared to that at 4-month. Although the TV value at 12-month of the affected hemisphere was out of reference range, TV was considerably increased compared to that at 4-month. Mean values for fractional anisotropy or mean diffusivity in 2 hemispheres did not show significant difference compared to those of control subjects regardless of month. LESSONS Restoration of an injured projection pathway between the vestibular nuclei and parieto-insular vestibular cortex with recovery of pusher syndrome was found in a patient with stroke.
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Affiliation(s)
- Sang Seok Yeo
- Department of Physical Therapy, College of Health Sciences, Dankook University
| | - Sung Ho Jang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University
| | - Seunghue Oh
- Department of Health, Graduate School, Dankook University, Republic of Kore
| | - Jung Won Kwon
- Department of Physical Therapy, College of Health Sciences, Dankook University
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32
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Bonuzzi GMG, de Freitas TB, Palma GCDS, Soares MAA, Lange B, Pompeu JE, Torriani-Pasin C. Effects of the brain-damaged side after stroke on the learning of a balance task in a non-immersive virtual reality environment. Physiother Theory Pract 2020; 38:28-35. [PMID: 32090670 DOI: 10.1080/09593985.2020.1731893] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Post-stroke survivors with right hemisphere injury have more impairments in postural control and balance. However, the impact of the hemisphere injured on the process of balance reacquisition has not been fully explored. We hypothesized that stroke survivors could learn balance tasks (H1), but right hemisphere damaged patients would show poor motor learning if compared to left hemisphere damaged patients (H2)Objective: To investigate whether the brain-damaged side after stroke affects the learning of a balance task. Methods: Three groups were recruited: twenty stroke survivors (ten left and ten right hemisphere damage) and twenty healthy volunteers. The participants practiced a balance task for thirty minutes, four consecutive days. The task was the Table Tilt game (NintendoTM Company), which induces balance demands with a progression of complexity. Motor performance was assessed at baseline, post-practice and after one week (retention test). Accuracy, errors, and complexity of the task achieved during the trial were assessedResults: Participants in all groups improved their performance (p < .001) and maintained it at the retention test. The control group showed better performance if compared to the right and left hemisphere damaged stroke survivors (p < .05). There was no difference between individuals with right and left hemisphere damaged, but the right hemisphere damaged patients demonstrated more errors at higher levels of complexityConclusion: Stroke survivors can learn balance tasks (H1), and the right hemisphere damaged patients demonstrate more errors than those with left hemisphere injury in higher complexity conditions (H2).
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Affiliation(s)
- Giordano Márcio Gatinho Bonuzzi
- Motor Behavior Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil.,Department of Physical Education, Piauí State University, Picos, Brazil
| | - Tatiana Beline de Freitas
- Motor Behavior Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | | | | | - Belinda Lange
- College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
| | - José Eduardo Pompeu
- Department of Physical Therapy, Speech Therapy and Occupational Therapy, University of São Paulo, São Paulo, Brazil
| | - Camila Torriani-Pasin
- Motor Behavior Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
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33
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Influence of unilateral spatial neglect on vertical perception in post-stroke pusher behavior. Neurosci Lett 2020; 715:134667. [DOI: 10.1016/j.neulet.2019.134667] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/23/2019] [Accepted: 11/30/2019] [Indexed: 11/19/2022]
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34
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Tilted writing after stroke, a sign of biased verticality representation. Ann Phys Rehabil Med 2020; 63:85-88. [DOI: 10.1016/j.rehab.2019.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 12/08/2019] [Accepted: 12/08/2019] [Indexed: 11/20/2022]
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35
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Chang TP, Winnick AA, Hsu YC, Sung PY, Schubert MC. The bucket test differentiates patients with MRI confirmed brainstem/cerebellar lesions from patients having migraine and dizziness alone. BMC Neurol 2019; 19:219. [PMID: 31481007 PMCID: PMC6720090 DOI: 10.1186/s12883-019-1442-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 08/22/2019] [Indexed: 12/12/2022] Open
Abstract
Background Amongst the most challenging diagnostic dilemmas managing patients with vestibular symptoms (i.e. vertigo, nausea, imbalance) is differentiating dangerous central vestibular disorders from benign causes. Migraine has long been recognized as one of the most common causes of vestibular symptoms, but the clinical hallmarks of vestibular migraine are notoriously inconsistent and thus the diagnosis is difficult to confirm. Here we conducted a prospective study investigating the sensitivity and specificity of combining standard vestibular and neurological examinations to determine how well central vestibular disorders (CVD) were distinguishable from vestibular migraine (VM). Method Twenty-seven symptomatic patients diagnosed with CVD and 36 symptomatic patients with VM underwent brain imaging and clinical assessments including; 1) SVV bucket test, 2) ABCD2, 3) headache/vertigo history, 4) presence of focal neurological signs, 5) nystagmus, and 6) clinical head impulse testing. Results Mean absolute SVV deviations measured by bucket testing in CVD and VM were 4.8 ± 4.1° and 0.7 ± 1.0°, respectively. The abnormal rate of SVV deviations (> 2.3°) in CVD was significantly higher than VM (p < 0.001). Using the bucket test alone to differentiate CVD from VM, sensitivity was 74.1%, specificity 91.7%, positive likelihood ratio (LR+) 8.9, and negative likelihood ratio (LR-) 0.3. However, when we combined the SVV results with the clinical exam assessing gaze stability (nystagmus) with an abnormal focal neurological exam, the sensitivity (92.6%) and specificity (88.9%) were optimized (LR+ (8.3), LR- (0.08)). Conclusion The SVV bucket test is a useful clinical test to distinguish CVD from VM, particularly when interpreted along with the results of a focal neurological exam and clinical exam for nystagmus. Electronic supplementary material The online version of this article (10.1186/s12883-019-1442-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tzu-Pu Chang
- Department of Neurology/Neuro-medical Scientific Center, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung City, Taiwan.,Department of Neurology, Tzu Chi University, Hualien, Taiwan
| | - Ariel A Winnick
- Soroka University Hospital and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yung-Chu Hsu
- Division of Neurology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Pi-Yu Sung
- Department of Physical Medicine and Rehabilitation, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung City, Taiwan
| | - Michael C Schubert
- Laboratory of Vestibular NeuroAdaptation, Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, 21205, USA. .,Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, 21205, USA.
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Mori L, Putzolu M, Bonassi G, Galeoto G, Mezzarobba S, Trompetto C, Avanzino L, Marchese R, Abbruzzese G, Pelosin E. Haptic perception of verticality correlates with postural and balance deficits in patients with Parkinson's disease. Parkinsonism Relat Disord 2019; 66:45-50. [DOI: 10.1016/j.parkreldis.2019.06.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/30/2019] [Accepted: 06/30/2019] [Indexed: 01/09/2023]
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Spatial orientation: Model-based approach to multi-sensory mechanisms. PROGRESS IN BRAIN RESEARCH 2019. [PMID: 31239133 DOI: 10.1016/bs.pbr.2019.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
Perception of spatial orientation is generated through multimodal sensory integration. In this process, there are systematic errors with changes in the head or body position, which reflect challenges for the brain in maintaining a common sensory reference frame for spatial orientation. Here, we focus on this multisensory aspect of spatial orientation. We review a Bayesian spatial perception model that can be used as a framework to study sensory contributions to spatial orientation during lateral head tilts and probe neural networks involved in this process.
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Dieterich M, Brandt T. Perception of Verticality and Vestibular Disorders of Balance and Falls. Front Neurol 2019; 10:172. [PMID: 31001184 PMCID: PMC6457206 DOI: 10.3389/fneur.2019.00172] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 02/08/2019] [Indexed: 11/16/2022] Open
Abstract
Objective: To review current knowledge of the perception of verticality, its normal function and disorders. This is based on an integrative graviceptive input from the vertical semicircular canals and the otolith organs. Methods: The special focus is on human psychophysics, neurophysiological and imaging data on the adjustments of subjective visual vertical (SVV) and the subjective postural vertical. Furthermore, examples of mathematical modeling of specific vestibular cell functions for orientation in space in rodents and in patients are briefly presented. Results: Pathological tilts of the SVV in the roll plane are most sensitive and frequent clinical vestibular signs of unilateral lesions extending from the labyrinths via the brainstem and thalamus to the parieto-insular vestibular cortex. Due to crossings of ascending graviceptive fibers, peripheral vestibular and pontomedullary lesions cause ipsilateral tilts of the SVV; ponto-mesencephalic lesions cause contralateral tilts. In contrast, SVV tilts, which are measured in unilateral vestibular lesions at thalamic and cortical levels, have two different characteristic features: (i) they may be ipsi- or contralateral, and (ii) they are smaller than those found in lower brainstem or peripheral lesions. Motor signs such as head tilt and body lateropulsion, components of ocular tilt reaction, are typical for vestibular lesions of the peripheral vestibular organ and the pontomedullary brainstem (vestibular nucleus). They are less frequent in midbrain lesions (interstitial nucleus of Cajal) and rare in cortical lesions. Isolated body lateropulsion is chiefly found in caudal lateral medullary brainstem lesions. Vestibular function in the roll plane and its disorders can be mathematically modeled by an attractor model of angular head velocity cell and head direction cell function. Disorders manifesting with misperception of the body vertical are the pusher syndrome, the progressive supranuclear palsy, or the normal pressure hydrocephalus; they may affect roll and/or pitch plane. Conclusion: Clinical determinations of the SVV are easy and reliable. They indicate acute unilateral vestibular dysfunctions, the causative lesion of which extends from labyrinth to cortex. They allow precise topographical diagnosis of side and level in unilateral brainstem or peripheral vestibular disorders. SVV tilts may coincide with or differ from the perception of body vertical, e.g., in isolated body lateropulsion.
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Affiliation(s)
- Marianne Dieterich
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University, Munich, Germany.,Department of Neurology, Ludwig-Maximilians University, Munich, Germany.,Munich Cluster for Systems Neurology, Munich, Germany
| | - Thomas Brandt
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University, Munich, Germany.,Clinical Neuroscience, Ludwig-Maximilians University, Munich, Germany
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Egocentric processing in the roll plane and dorsal parietal cortex: A TMS-ERP study of the subjective visual vertical. Neuropsychologia 2019; 127:113-122. [DOI: 10.1016/j.neuropsychologia.2019.02.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/29/2019] [Accepted: 02/28/2019] [Indexed: 11/18/2022]
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40
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Bergmann J, Krewer C, Müller F, Jahn K. A new cutoff score for the Burke Lateropulsion Scale improves validity in the classification of pusher behavior in subactue stroke patients. Gait Posture 2019; 68:514-517. [PMID: 30623845 DOI: 10.1016/j.gaitpost.2018.12.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 12/20/2018] [Accepted: 12/25/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Pusher behavior substantially hampers balance during sitting, standing, and posture transitions in stroke patients. The Burke Lateropulsion Scale (BLS) was recommended to evaluate pusher behavior. However, its cutoff score has not been validated and recent studies found evidence for a need to modify it. As there is no gold standard for the diagnosis of pusher behavior, functions that are typically disturbed in these patients should be used for the validation of the cutoff score. RESEARCH QUESTION To investigate whether pusher behavior correlates with balance performance during sitting, standing and posture transitions, and to validate the BLS cutoff score. METHODS 44 subacute stroke patients with pusher behavior (BLS ≥ 2) were included in this study. The BLS and the Performance-Oriented Mobility Assessment Balance subscale (POMA-B) were assessed several times at intervals of two weeks resulting in a total of 137 data sets. RESULTS Correlation analysis between the BLS score and the POMA-B score revealed a moderate negative correlation (rSp=-0.602, p < 0.001): The lower the BLS score, the higher the balance performance. The maximum Youden Index (J=0.864) was found for a cutoff score ≥2.5. Patients with a BLS score ≥2 scored ≥1 on the POMA-B, while patients with a BLS score ≥3 scored at no item or only at the sitting balance task. SIGNIFICANCE In line with previous findings, the results of this study support using a BLS cutoff score of ≥3 instead of ≥2 to diagnose PB for research purposes and intervention planning. A score ≥3 correlates with severe balance impairments and with an impaired verticality perception in the frontal plane, and it improves the agreement with the Scale for Contraversive Pushing.
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Affiliation(s)
- Jeannine Bergmann
- Schoen Klinik Bad Aibling, Kolbermoorer Strasse 72, 83043 Bad Aibling, Germany; German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians-University of Munich, Marchioninistr. 15, 81377 Munich, Germany.
| | - Carmen Krewer
- Schoen Klinik Bad Aibling, Kolbermoorer Strasse 72, 83043 Bad Aibling, Germany.
| | - Friedemann Müller
- Schoen Klinik Bad Aibling, Kolbermoorer Strasse 72, 83043 Bad Aibling, Germany; German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians-University of Munich, Marchioninistr. 15, 81377 Munich, Germany.
| | - Klaus Jahn
- Schoen Klinik Bad Aibling, Kolbermoorer Strasse 72, 83043 Bad Aibling, Germany; German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians-University of Munich, Marchioninistr. 15, 81377 Munich, Germany.
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Le Berre M, Pradeau C, Brouillard A, Coget M, Massot C, Catanzariti JF. Do Adolescents With Idiopathic Scoliosis Have an Erroneous Perception of the Gravitational Vertical? Spine Deform 2019; 7:71-79. [PMID: 30587324 DOI: 10.1016/j.jspd.2018.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 04/28/2018] [Accepted: 05/05/2018] [Indexed: 10/27/2022]
Abstract
STUDY DESIGN Multicenter, case-control study. OBJECTIVES Demonstrate altered perception of verticality in AIS compared with matched controls. SUMMARY OF BACKGROUND DATA The cause of adolescent idiopathic scoliosis (AIS) remains to be found. AIS is associated with neurosensorial anomalies, in particular, altered control of orthostatic posture. During kinetic activity, the upright posture, in humans, is determined in reference to the gravitational vertical (GV). We hypothesized that in AIS, there is a discordance in the perception of the GV and the true GV. In AIS, the longitudinal axis of the body would thus be misoriented because of an erroneous perception of the GV. METHODS Thirty adolescents with right thoracic AIS (age 14.23 ± 1.75 years; Cobb angle 31.97°± 12.83°) and 30 controls matched for age (13.93 ± 1.85 years), body mass index, Tanner stage, and handedness were compared for subjective visual vertical (SVV) measured in static and dynamic (optokinetic stimulation) conditions, and subjective postural vertical (SPV). RESULTS There was no difference in the two groups, AIS and controls, for SVV. The SPV was significantly different between the two groups (p = .00023). The SPV was shifted to the right for most of the AIS patients (2.13°± 2.22°) compared with controls (-0.08°±1.40°). There was a significant correlation between SPV and clinical frontal tilt in the AIS patients. CONCLUSION Our findings demonstrate that patients with right thoracic AIS have an erroneous perception of the GV. In most AIS patients, SPV was shifted to the right, with no alteration of the SVV. AIS might be the consequence of a reoriented longitudinal body axis aligned with an erroneous vertical reference. The underlying mechanism might involve dysfunction of trunk graviceptors. The primary or secondary nature of this dysfunction remains an open question.
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Affiliation(s)
- Morgane Le Berre
- Physical Medicine and Rehabilitation Department, Swynghedauw University Hospital Center, Lille, France
| | - Charles Pradeau
- Physical Medicine and Rehabilitation Department, Swynghedauw University Hospital Center, Lille, France
| | | | - Monique Coget
- Spine department, SSR pediatric center Marc Sautelet, Villeneuve-d'Ascq, France
| | - Caroline Massot
- Physical Medicine and Rehabilitation Department, Saint Philibert University Hospital Center, Lomme 59462, France
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Conceição LB, Baggio JAO, Mazin SC, Edwards DJ, Santos TEG. Normative data for human postural vertical: A systematic review and meta-analysis. PLoS One 2018; 13:e0204122. [PMID: 30265701 PMCID: PMC6161851 DOI: 10.1371/journal.pone.0204122] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 09/04/2018] [Indexed: 02/05/2023] Open
Abstract
Perception of verticality is required for normal daily function, yet the typical human detection error range has not been well characterized. Vertical misperception has been correlated with poor postural control and functionality in patients after stroke and after vestibular disorders. Until now, all the published studies that assessed Subjective Postural Vertical (SPV) in the seated position used small groups to establish a reference value. However, this sample size does not represent the healthy population for comparison with conditions resulting in pathological vertical. Therefore, the primary objective was to conduct a systematic review with meta-analyses of Subjective Postural Vertical (SPV) data in seated position in healthy adults to establish the reference value with a representative sample. The secondary objective was to investigate the methodological characteristics of different assessment protocols of SPV described in the literature. A systematic literature search was conducted using Medline, EMBASE, and Cochrane libraries. Mean and standard deviation of SPV in frontal and sagittal planes were considered as effect size measures. Sixteen of 129 identified studies met eligibility criteria for our systematic review (n = 337 subjects in the frontal plane; n = 187 subjects in sagittal plane). The meta-analyses measure was estimated using the pooled mean as the estimator and its respective error. Mean reference values were 0.12°±1.49° for the frontal plane and 0.02°±1.82° for the sagittal plane. There was a small variability of the results and this systematic review resulted in representative values for SPV. The critical analysis of the studies and observed homogeneity in the sample suggests that the methodological differences used in the studies did not influence SPV assessment of directional bias in healthy subjects. These data can serve as a reference for clinical studies in disorders of verticality.
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Affiliation(s)
| | - Jussara A O Baggio
- Department of Neuroscience and Behavioral Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, São Paulo, Brazil.,Federal University of Alagoas, Arapiraca, Alagoas, Brazil
| | - Suleimy C Mazin
- Department of Neuroscience and Behavioral Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, São Paulo, Brazil.,Department of Obstetrics and Gynecology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, São Paulo, Brazil
| | - Dylan J Edwards
- Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania, United States of America.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Taiza E G Santos
- Department of Neuroscience and Behavioral Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, São Paulo, Brazil
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43
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Bergmann J, Krewer C, Jahn K, Müller F. Robot-assisted gait training to reduce pusher behavior: A randomized controlled trial. Neurology 2018; 91:e1319-e1327. [PMID: 30171076 DOI: 10.1212/wnl.0000000000006276] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 07/02/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine the effects of 2 weeks of intensive robot-assisted gait training (RAGT) on pusher behavior compared to nonrobotic physiotherapy (nR-PT). METHODS In a single-blind, randomized, controlled trial with 2 parallel arms, we compared 2 weeks of daily RAGT (intervention group) with the same amount of nR-PT (control group). Patients with subacute stroke who had pusher behavior according to the Scale for Contraversive Pushing (SCP) were included. The primary research questions were whether changes in pusher behavior would differ between groups post intervention, and at a follow-up 2 weeks afterward (SCP and Burke Lateropulsion Scale, Class II evidence). Secondary outcomes included the Performance-Oriented Mobility Assessment, the Functional Ambulation Classification, and the Subjective Visual Vertical. RESULTS Thirty-eight patients were randomized. Thereof, 30 patients received the allocated intervention and were included in the analyses. RAGT led to a larger reduction of pusher behavior than nR-PT at post test (SCP: U = 69.00, r = -0.33, p = 0.037; Burke Lateropulsion Scale: U = 47.500, r = -0.50, p = 0.003) and at follow-up (SCP: U = 54.00, r = -0.44, p = 0.008). Pusher behavior had ceased in 6 of 15 participants in the intervention group and 1 of 15 participants in the control group at post test. At follow-up, 9 of 15 and 5 of 15 participants, respectively, no longer exhibited the behavior. CONCLUSIONS Two weeks of RAGT seems to persistently reduce pusher behavior, possibly by recalibrating the disturbed inner reference of verticality. The potential benefits of RAGT on pusher behavior and verticality perception require further investigation. TRIAL REGISTRATION German Clinical Trials Register (registration number: DRKS00003444). CLASSIFICATION OF EVIDENCE This study provides Class II evidence that RAGT is beneficial to reduce pusher behavior in patients with stroke.
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Affiliation(s)
- Jeannine Bergmann
- From the Schoen Klinik Bad Aibling; and German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University of Munich, Germany.
| | - Carmen Krewer
- From the Schoen Klinik Bad Aibling; and German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University of Munich, Germany
| | - Klaus Jahn
- From the Schoen Klinik Bad Aibling; and German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University of Munich, Germany
| | - Friedemann Müller
- From the Schoen Klinik Bad Aibling; and German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University of Munich, Germany
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44
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Disturbances of spatial reference frame and postural asymmetry after a chronic stroke. Exp Brain Res 2018; 236:2377-2385. [DOI: 10.1007/s00221-018-5308-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 06/05/2018] [Indexed: 01/24/2023]
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45
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Negrillo-Cárdenas J, Rueda-Ruiz AJ, Ogayar-Anguita CJ, Lomas-Vega R, Segura-Sánchez RJ. A System for the Measurement of the Subjective Visual Vertical using a Virtual Reality Device. J Med Syst 2018; 42:124. [DOI: 10.1007/s10916-018-0981-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 05/18/2018] [Indexed: 10/14/2022]
Affiliation(s)
- José Negrillo-Cárdenas
- Department of Computer Science, University of Jaén, Campus Las Lagunillas s/n, A3 building, 23071, Jaén, Spain.
| | - Antonio J Rueda-Ruiz
- Department of Computer Science, University of Jaén, Campus Las Lagunillas s/n, A3 building, 23071, Jaén, Spain
| | - Carlos J Ogayar-Anguita
- Department of Computer Science, University of Jaén, Campus Las Lagunillas s/n, A3 building, 23071, Jaén, Spain
| | | | - Rafael J Segura-Sánchez
- Department of Computer Science, University of Jaén, Campus Las Lagunillas s/n, A3 building, 23071, Jaén, Spain
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46
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An Overview of the Physiology and Pathophysiology of Postural Control. BIOSYSTEMS & BIOROBOTICS 2018. [DOI: 10.1007/978-3-319-72736-3_1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Cuturi LF, Gori M. The Effect of Visual Experience on Perceived Haptic Verticality When Tilted in the Roll Plane. Front Neurosci 2017; 11:687. [PMID: 29270109 PMCID: PMC5723665 DOI: 10.3389/fnins.2017.00687] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 11/22/2017] [Indexed: 11/13/2022] Open
Abstract
The orientation of the body in space can influence perception of verticality leading sometimes to biases consistent with priors peaked at the most common head and body orientation, that is upright. In this study, we investigate haptic perception of verticality in sighted individuals and early and late blind adults when tilted counterclockwise in the roll plane. Participants were asked to perform a stimulus orientation discrimination task with their body tilted to their left ear side 90° relative to gravity. Stimuli were presented by using a motorized haptic bar. In order to test whether different reference frames relative to the head influenced perception of verticality, we varied the position of the stimulus on the body longitudinal axis. Depending on the stimulus position sighted participants tended to have biases away or toward their body tilt. Visually impaired individuals instead show a different pattern of verticality estimations. A bias toward head and body tilt (i.e., Aubert effect) was observed in late blind individuals. Interestingly, no strong biases were observed in early blind individuals. Overall, these results posit visual sensory information to be fundamental in influencing the haptic readout of proprioceptive and vestibular information about body orientation relative to gravity. The acquisition of an idiotropic vector signaling the upright might take place through vision during development. Regarding early blind individuals, independent spatial navigation experience likely enhanced by echolocation behavior might have a role in such acquisition. In the case of participants with late onset blindness, early experience of vision might lead them to anchor their visually acquired priors to the haptic modality with no disambiguation between head and body references as observed in sighted individuals (Fraser et al., 2015). With our study, we aim to investigate haptic perception of gravity direction in unusual body tilts when vision is absent due to visual impairment. Insofar, our findings throw light on the influence of proprioceptive/vestibular sensory information on haptic perceived verticality in blind individuals showing how this phenomenon is affected by visual experience.
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Affiliation(s)
- Luigi F Cuturi
- Unit for Visually Impaired People, Science and Technology for Children and Adults, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Monica Gori
- Unit for Visually Impaired People, Science and Technology for Children and Adults, Istituto Italiano di Tecnologia, Genoa, Italy
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Kheradmand A, Winnick A. Perception of Upright: Multisensory Convergence and the Role of Temporo-Parietal Cortex. Front Neurol 2017; 8:552. [PMID: 29118736 PMCID: PMC5660972 DOI: 10.3389/fneur.2017.00552] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 09/28/2017] [Indexed: 12/18/2022] Open
Abstract
We inherently maintain a stable perception of the world despite frequent changes in the head, eye, and body positions. Such "orientation constancy" is a prerequisite for coherent spatial perception and sensorimotor planning. As a multimodal sensory reference, perception of upright represents neural processes that subserve orientation constancy through integration of sensory information encoding the eye, head, and body positions. Although perception of upright is distinct from perception of body orientation, they share similar neural substrates within the cerebral cortical networks involved in perception of spatial orientation. These cortical networks, mainly within the temporo-parietal junction, are crucial for multisensory processing and integration that generate sensory reference frames for coherent perception of self-position and extrapersonal space transformations. In this review, we focus on these neural mechanisms and discuss (i) neurobehavioral aspects of orientation constancy, (ii) sensory models that address the neurophysiology underlying perception of upright, and (iii) the current evidence for the role of cerebral cortex in perception of upright and orientation constancy, including findings from the neurological disorders that affect cortical function.
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Affiliation(s)
- Amir Kheradmand
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Department of Otolaryngology – Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Ariel Winnick
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Visual verticality perception after stroke: A systematic review of methodological approaches and suggestions for standardization. Ann Phys Rehabil Med 2017; 60:208-216. [PMID: 27079584 DOI: 10.1016/j.rehab.2016.02.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 02/03/2016] [Accepted: 02/07/2016] [Indexed: 11/22/2022]
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50
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Jahn K, Müller F, Koenig E, Krewer C, Tillmann S, Bergmann J. Rehabilitation of verticality perception using a new training method. J Neurol 2017; 264:26-27. [PMID: 28321565 DOI: 10.1007/s00415-017-8435-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 02/21/2017] [Accepted: 02/22/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Klaus Jahn
- German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians-University of Munich, University Hospital Grosshadern, Munich, Germany.
- Department of Neurology, Schoen Klinik Bad Aibling, Kolbermoorer Strasse 72, Bad Aibling, 83043, Bad Aibling, Germany.
| | - Friedemann Müller
- Department of Neurology, Schoen Klinik Bad Aibling, Kolbermoorer Strasse 72, Bad Aibling, 83043, Bad Aibling, Germany
| | - Eberhard Koenig
- Department of Neurology, Schoen Klinik Bad Aibling, Kolbermoorer Strasse 72, Bad Aibling, 83043, Bad Aibling, Germany
| | - Carmen Krewer
- Department of Neurology, Schoen Klinik Bad Aibling, Kolbermoorer Strasse 72, Bad Aibling, 83043, Bad Aibling, Germany
| | - Susanne Tillmann
- Department of Neurology, Schoen Klinik Bad Aibling, Kolbermoorer Strasse 72, Bad Aibling, 83043, Bad Aibling, Germany
| | - Jeannine Bergmann
- German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians-University of Munich, University Hospital Grosshadern, Munich, Germany
- Department of Neurology, Schoen Klinik Bad Aibling, Kolbermoorer Strasse 72, Bad Aibling, 83043, Bad Aibling, Germany
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